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Treating substance abuse among patients with schizophrenia
1University of Maryland School of Medicine, Baltimore 21201, USA. abellack@umabnet.ab.umd.edu
Psychiatric Services (Washington, D.C.)
|January 16, 1999
Summary
Effective treatment for substance abuse in schizophrenia requires a staged approach, adapting the transtheoretical model to address cognitive deficits. This involves modules on social skills, education, motivation, and relapse prevention over six months.
Area of Science:
- Psychiatry
- Psychology
- Addiction Medicine
Background:
- Substance abuse is highly prevalent in individuals with schizophrenia.
- Effective treatment strategies for this dual diagnosis are not well-established.
- Cognitive and motivational deficits in schizophrenia complicate treatment.
Purpose of the Study:
- To propose an adapted transtheoretical model for treating substance abuse in schizophrenia.
- To outline a structured, modular treatment protocol.
- To address the unique challenges faced by this patient population.
Main Methods:
- Adaptation of the transtheoretical model of change.
- A six-month treatment protocol with four distinct modules.
- Twice-weekly, 90-minute sessions emphasizing behavioral rehearsal and skill-building.
Main Results:
- The protocol integrates social skills, education, motivational interviewing, and relapse prevention.
- Complex behaviors like substance refusal are broken down into manageable steps.
- The approach aims to minimize the impact of schizophrenia-related deficits.
Conclusions:
- A staged, adapted transtheoretical model offers a promising framework for treating co-occurring substance abuse in schizophrenia.
- The modular, skills-based approach addresses critical treatment elements.
- Further research is needed to validate the efficacy of this adapted model.